From
The Desk Of Clarence Bass

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“My approach is not another stop-gap solution, it prevents
heart disease from occurring in those who don’t yet have the disease, and it
heals the body and reverses the disease when symptoms are present.” Caldwell B.
Esselstyn, Jr., MD, author of Prevent and Reverse Heart Disease (Avery,
2007)

“We must never underestimate the layman’s ability to adopt
healthier lifestyles. We must tell the truth.” Caldwell B. Esselstyn, Jr., MD

Preventing and Reversing Heart Disease

Real People, Real Results

If you were told that a strict plant-based diet would
prevent and even reverse heart disease, would you adopt the diet? What if you
had advanced heart disease and were facing open-heart surgery or balloon
angiography? Based on clinical experience, conventional medicine says you are
not likely to radically change your diet in either case. Caldwell B. Esselstyn,
Jr., MD, formerly a surgeon, researcher and clinician at the Cleveland Clinic,
says the odds are high that you would chose the diet—if your doctor took the
time to fully and completely explain the benefits. Both are probably correct.
Most people are not willing to change. Nevertheless, we should be given full
information and every opportunity to help ourselves.

You should know about the success Dr. Esselstyn has
had with diet and, if necessary, minimal use of cholesterol-lowering drugs.

His diet rules are simple—and strict: All vegetables,
fruit, whole grains, beans and lentils are allowed; but no meat, chicken, fish,
eggs, refined grains, dairy products (even skim milk), oil, nuts or avocados. In
short, eliminate all fats except those found in plant-based foods; no animal
foods or concentrated fats (oil, nuts). His aim is to avoid any food known to
cause or promote vascular disease. If you are free of heart disease, walnuts in
moderation are permitted. Esselstyn acknowledges that the omega-3 fatty acids
found in fish are essential to artery health and other bodily functions, but
prefers to use plant sources, such as flaxseed.

Although his diet sounds—and is—Spartan, Dr. Esselstyn’s
meal suggestions are more satisfying—rabbit food it’s not—than you might think.
(Example below) And, the choices begin to have more appeal when you
learn the results of his 20-year nutritional study.

Study Results

The patients in the study had advanced heart disease. They
were literally at death’s door. Despite aggressive treatment—think bypass and
stents—most were told they had less than a year to live. They were referred to
Dr. Esselstyn as a last resort. He sat down with each patient for up to an hour
(as long as necessary) and explained the benefits of plant-based nutrition. He
also explained that surgical repairs do not stop the progression of the
underlying disease; that lifestyle change is the only way to stop or reverse
their disease. He
gave them reason for hope.

Within months on Dr. Esselstyn’s program, their cholesterol
levels, angina symptoms, and blood flow improved dramatically. Twenty years
later, most of them are still alive. Sounds almost too good
to be true, doesn’t it? Here are the details.

Six patients opted out; they did not grasp what Dr.
Esselstyn was trying to do and were not willing to follow the diet. (What
eventually happened to these six is in Dr. Esselstyn’s book.) Seventeen patients
signed on to the program. Each was put on a plant-based diet and given a
prescription for a cholesterol-lowering drug. Every two weeks for five
years—this is very important—Esselstyn contacted each patient to go over what
they were eating, cholesterol readings, problems, etc., and make necessary
changes in their nutrition or medication. This level of contact is, of course,
almost unprecedented. It really paid off. It was the key to keeping them on the
diet. The continuous encouragement and guidance—and the symptom relief they were
experiencing.

Dr. Esselstyn goes over the history of each patient in his
book, but here is an overview of what happened.

One patient, who was accepted into the program after
sustaining massive heart damage (function reduced to 20%), died after surviving five years on the program. Despite showing
improved blood supply and decrease in angina, he died of cardiac arrhythmia.
“Postmortem study showed no new blockages or heart attacks,” Dr. Esselstyn
relates. The other patients improved and survived.

As a group, the patients began the study with average total
blood cholesterol of 246; desirable is 200 or less. By adhering to the diet and
using cholesterol-lowering drugs, their average cholesterol dropped to 137; less
than 150 is ideal and considered protective. Their cholesterol went from “high risk” to “safe” on the program. “Below 150 is the
total cholesterol level seen in cultures where heart disease is essentially
nonexistent,” Dr. Esselstyn tells us. Every participant achieved a total
cholesterol level below 150.

Almost half of the participants showed a widening of their
coronary arteries—an actual reversal of their disease. This is not opinion; it
is documented fact. Angiogram X-ray pictures were taken at the beginning of the
program, and after five years. “At the five-year mark, seven of the eighteen
participants were unable to have a follow-up angiogram,” Dr. Esselstyn writes.
“The results I report here are for the eleven participants who did have
follow-up angiograms after five years. The analyses were stunning. In sustaining
cholesterol readings below 150, these patients eliminated any clinical
progression of their disease. Every single one arrested progression of the heart
disease, and eight participants actually selectively reversed it.” A color
insert in the book shows the angiogram pictures. You can see the improved blood
flow, in some cases after only 3 weeks. The results are indeed stunning.

Finally, and most importantly, for all participants,
symptoms improved. “Nine of the patients had come to the study with angina—pain
in the heart muscle caused by inadequate blood supply,” Dr. Esselstyn reports.
“It was completely eliminated in two and much improved in the remaining seven,
including the patient who died. Exercise capacity improved. Sexual activity was
enhanced.”

The Explanation

Here’s how Dr. Esselstyn describes what happened to the
people in the study: “The blood supply through their coronary arteries to their
heart muscles has improved. In the majority of patients, the arteries themselves
are measurably wider.” Exploring the causative factors, Dr. Esselstyn continues:
“Profound reduction of cholesterol has increased the capacity of the
endothelium, the arteries’ inner lining, to produce nitric oxide, which in turn
dilates [expands] the arteries themselves—even diseased arteries.” On the role
of the diet, he adds: “The patients’ plant-based diet, eliminating the ingestion
of foods that injure vascular tissues, has restored strength and integrity to
the endothelium as a whole.” Importantly, “Any plaques in these patients were
protectively capped and could not rupture or initiate the cascade of clotting
that defines a heart attack.”

“These patients are now heart-attack-proof,” Esselstyn
states emphatically.

Inspired?

I’m impressed—and encouraged. My diet is largely
plant-based, but not as strict as Dr. Esselstyn would like. “I stress the need
for total commitment,” says the doctor. “My first request is that patients and
their families eliminate from their vocabulary, from their thinking, from their
basic belief systems, the phrase ‘This little bit can’t hurt.’” He adds “that
just a little bit of forbidden food—fats, dairy products, oils, animal proteins—can
hurt, and will.”

I wouldn’t pass muster, because I use a small amount of
canola oil, measured amounts of nut butter, several cups of skim milk and
non-fat yogurt, and frequently have modest portions of fish or (less often)
chicken with my evening meal. I also eat two to four eggs a week. (A major study
from Harvard found no association between eggs and heart disease, except in
people with diabetes.)

This seems to be working well for me, based on the
results of my latest blood test.

My total cholesterol is 158, about 5% over Dr. Esselstyn’s
“safe” number. I believe that puts me in a pretty good place, because my HDL
“good” cholesterol, at 62, is almost twice the 36-average level for the
participants in Dr. Esselstyn’s study. My total cholesterol-HDL ratio is
substantially better than the study participants, 2.55 to 3.8; <4.5 is
considered acceptable. My LDL “bad” cholesterol, at 82, is the same as the
average for the participants, but my HDL-LDL ratio is far better, 1.32 compared
to 2.28.

I believe my high HDL is due to daily exercise (weights,
aerobics or walking), something that Esselstyn encourages, but does not require.

Carol and I are making some changes, nevertheless. For one
thing, we’re going to include Dr. Esselstyn’s “thick soup” suggestions several
times a week in our evening meal. We’ve already tried the “Sweet Potato and
Lentil Soup with Shiitake Mushroom.” It’s delicious and very satisfying. We’re
also looking for other places to use Esselstyn’s recipes, and reduce unhealthy
fat. (Some fat in the diet is desirable. Adding a tablespoon of oil—olive and
then flaxseed—reduced my triglycerides by half; see article 18 in our Diet &
Nutrition category for the details.)

Could your diet be improved? Before you decide, I encourage
you to read Dr. Esselstyn’s inspiring book Prevent and Reverse Heart Disease
(Penguin, 2007). A paperback version was just released (January, 2008). I
ordered mine on Amazon, but you can probably find it in your local book store.
It’s also offered on Dr. Esselstyn’s website: www.heartattackproof.com.